60,000 killed, 10,000 disappeared and 160,000 displaced.
This is the ongoing tragedy that has been wrought upon the Mexican people in the few short years since Felipe Calderón declared a “war on cartels” in December, 2006.
Javier Sicilia, the famed Mexican poet, stopped writing poetry after his son was gunned down in Cuernavaca in March, 2011. On the day his son died he wrote one final verse before putting down his pen: “the world is not worthy of words, they have been suffocated from the inside, just as they suffocated you.”
CC photo by Caravan4Peace
Since then he has been taking to the streets of Mexico, with hundreds of thousands of other citizens in a dramatic plea to the drug cartels and the government to stop the violence that has been tearing apart their country. Sicilia, as he is known in Mexico, led two Caravans for Peace – one from Cuernavaca to Mexico City and the other through the north of Mexico, where the violence has been beyond comprehension.
On August 12th, Sicilia led close to a hundred victims of the drug war in Mexico across the border from Tijuana to San Diego to begin a month-long Caravan for Peace across the southern and north eastern US. The overarching message of the Caravan for Peace is that the war on drugs continues to devastate his country and is the result of drug policies initiated in the U.S., Canada and Mexico. CDPC will be joining the Caravan for Peace in Baltimore, Maryland on September 9th as it stops to hold a Town Hall Meeting on drug policy that will look at how all three countries have much to gain by considering alternatives to a failed war on drugs.
Follow our blog in the coming weeks to read more about the Caravan for Peace, Javier Sicilia, and Canada’s relationship to Mexico’s drug war.
The dust has settled on the most recent International AIDS Conference that took place July 22 – 27th in Washington DC. The Canadian Drug Policy Coalition was there on the ground, taking part in the many sessions and events that took place at this bi-annual gathering. Holding the event in DC, ground-zero for the war on drugs, is what made this year’s conference so special and yet so disappointing at the same time.
Donald MacPherson and Alan Clear at CDPC booth
In recent years, a strong argument has been made by the world’s leading HIV/AIDS scientists, physicians, and activists that global drug policies, directly responsible for one third of new HIV infections in the world, must be reviewed if efforts to slow or halt the epidemic are to be successful. The emergence of initiatives like the Vienna Declaration , organizations like International Doctors for Healthy Drug Policies, and the International Centre for Science in Drug Policy are testaments to the concern about the harms that global drug policies are causing world-wide.
What was most disappointing about the conference was the lack of focus on drug policy and its contribution to the global epidemic.
AIDS Action Now
There was little in the official program that acknowledged that the criminalization of drugs and those who use them is a key driver of increased risk of HIV transmission. There was absolutely no mention of this issue in any of the opening ceremonies of the conference. On the other hand, in the Global Village (the community organized venue that takes place parallel to the conference but outside the main event) there were many events, actions, discussions, and panels that highlighted the importance of finding alternative drug policies that worked better to protect public health, reduce stigma and uphold the human rights of people who use drugs.
Canada’s Federal Minister of Health, Leona Aglukkaq, was given a hostile reception by many of the Canadians in attendance over the federal government’s lack of support for harm reduction, cuts to HIV AIDS organizations and the denial of health care benefits for refugee claimants. The video of this action can be found here http://www.aidsactionnow.org/
CDPC created a live-blog for AIDS 2012 to follow the issues raised at the conference. Check it out for stories, videos and commentary on the relationship between drug policy and HIV/AIDS.
Watch Now
We also delivered a newspaper that flew off the stands at the CDPC booth in the Global Village. Thanks to the wonderful design team that helped us put it together. It was a real hit!
The opening session of AIDS 2012 is the anchor event for many attendees. This is the place where world leaders in the AIDS movement say their piece and inspire attendees to continue their work. Speakers at this year’s session were numerous and notable, including World Bank President Jim Yong Kim, who delivered the message that his organization cares and wants to see more involvement of civil society in shaping global anti-poverty programs (despite years of insisting that countries scale down their social safety nets to receive World Bank financial assistance). The conference co-chairs, Diane Havlir and Elly Katabira, along with the Deputy President of South Africa also urged conference attendees to embrace the goal of eliminating HIV in our generation. All good stuff.
New Vienna Declaration Ad
The highlight of the evening was Annah Sango from the International Community of Women Living with HIV/AIDS who spoke most poignantly about the need to integrate women’s issues into the international AIDS agenda. She praised the work of NGO’s addressing the needs of people who use drugs and reminded the audience that the way forward cannot proceed without the voices of those most affected, including people who use drugs, women, and sex workers. Speakers made it clear that organizations focused on AIDS in a global context have had major successes at scaling up prevention and treatment. Yet it was apparent that discussion of controversial issues like the decriminalization or even legalization of drugs was a nonstarter. Last night’s speakers briefly mentioned needle exchange but the overall framework of global drug policy was clearly not on the agenda.
These profound absences were supposed to be remedied by the 2010 Vienna Declaration. But the lack of drug policy discussion last night makes it clear why CDPC’s presence is needed in Washington this week. Our work is to remind attendees that drug policy is AIDS policy and that harm reduction interventions and a discussion of legal frameworks should not only be up for discussion, but are central to the conference’s goal of an AIDS-free generation.
The CDPC is in Washington D.C., for AIDS 2012 – a sprawling conference and gathering that attracts some 25,000 people from across the world. Yesterday we attended a day-long satellite meeting on the “Twin Epidemics of HIV and Drug Use”. It was an intriguing mix of solo speakers and panel presentations.
Gil Kerlikowske, U.S. Drug Czar, kicked off the day with a short talk about American drug policy. He talked about the U.S.’s new approach to drugs as a “third way”, though I’m not sure he spelled out the other two ways. Clearly he wanted his audience to appreciate that the U.S. War on Drugs was coming to an end. But the deployment of American law enforcement along the Mexican border, in Honduras and parts of Africa might suggest otherwise.
Photo via HCLU
Kerlikowske took pains to talk about his support for a public health approach to drug use and praised his government’s support for the 2,600 drug courts already in existence in the U.S. However, he did not mention some of the issues inherent to the quasi-coercive methods used by these courts.
He also made clear his support for needle exchange, though was careful to note that Congress had tied his hands by banning federal funding for syringe distribution in 2011. He ended with a vague call for a “critical convergence” between public health and public safety. His definition of public health was clear from his earlier remarks, but his definition of public safety remained a small mystery, though he is likely referring to a continuation of the criminalization of some drugs.
Liz Evans from the Portland Hotel Society gave an impassioned presentation of the successes of Vancouver’s supervised injection site, Insite. Panel presentations ran the gamut. There was much discussion about the need to scale-up harm reduction interventions that can reduce HIV transmission. Speakers praised efforts to increase the availability of methadone, needle exchange, treatment, detox, and overdose prevention programs.
There was talk about the UNAIDS goal to reduce HIV infections by 50% among people who use drugs. Presentations examined the gap between what countries are willing to do and what’s needed. Over and over again, it was clear that civil society organizations with the support of the Global Fund and the Open Society Foundations carry the lion’s share of responsibility for harm reduction services around the world.
Funding for these groups is often precarious and time-sensitive. Speakers from the Global Fund advised audience members that the Fund is undergoing a review of its proposal processes and its approach to funding harm reduction. Clearly, audience members were worried that this might spell an end to the Fund’s support for harm reduction. We were advised to contact board members at the Fund to press our case for the continuation of harm reduction funding.
It likely won’t come as much of a surprise that U.S. concerns shaped the agenda for this meeting. Congress’s decision to withdraw funding for needle exchange underscored the stigma that shapes the lives of people who use illegal drugs. With this ban in place, it was difficult for some U.S. attendees to move beyond discussion of needle exchange to programs like supervised injection and heroin assisted treatment. Daniel Wolf from the Open Society Foundations pressed U.S. representatives to help audience members make sense of Congress’s decision and it was clear from their responses that promoting discrimination against people who use drugs is still politically useful in the U.S. There was also a curious sentiment among U.S. attendees: their hope for more meaningful drug reform measures in Obama’s second term (if he wins in November).
Some of the speakers spoke of their drug use histories and reminded audience members to focus on the whole person in their efforts to stem HIV infections. Representatives from civil society organizations including those in the U.S. talked about the needs of the people they serve and decried the deeply “resource scarce” environments in which they operate.
Over and over again some speakers spoke of the vulnerable groups who need harm reduction services, including men who have sex with men, people who use drugs and sex workers. So much so, that a speaker from New York’s Harm Reduction Coalition challenged some of these presenters to avoid re-marginalizing people with language that both fails to recognize the diversity within these groups and frames these groups as problems to be solved. As this critic noted, it was clear that politicians and world leaders were clearly the problem when it comes to meeting the needs of people who use drugs.
All in all, the day ended with a feel good sentiment but not much consensus on how to move forward. Speakers acknowledged that practical solutions exist, but are often politically unpopular. In the coming days, we look forward to deeper discussions at the conference about how to scale-up proven programs like needle exchange and supervised consumption.
Drug treatment courts (DTC’s) are often touted as the solution to a cycle of drug addiction and crime. But are they? That’s the question the Canadian HIV/AIDS Legal Network sought to answer in a 2011 publication that reviews the operations of six federally funded drug courts in Canada (Toronto, Edmonton, Vancouver, Winnipeg, Ottawa and Regina). This study is also a detailed primer on drug courts for the uninitiated. The report does not completely dismiss DTC’s but raises some serious questions about how they operate and their effectiveness.
Photo: Some rights reserved by s_falkow
The notion that addiction is the result of a moral failing sometimes gives way to the idea that it’s a chronic illness that will respond to medical treatment. But as this report points out, drug courts operate on a combination of these assumptions.
Promoted as a way to reduce drug use and prevent crime, drug courts embrace the idea that treatment can alleviate addiction.
But they also use quasi-coercive and punishing methods more akin to the criminal justice system. Applicants to a drug court treatment program must plead guilty to a crime and submit to a mandatory urine screening. Failure to adhere to the court ordered treatment program can mean a prison sentence. But if addiction is a chronic relapsing illness as the United Nations Office on Drugs and Crimes suggests it is, how well does it respond to these quasi-coercive techniques used in drug courts? Not that well according to the authors of this report.
This report also raises serious questions about the methodology of research on drug courts. Its authors argue that given the lack of follow-up research on the experiences of participants, and the low retention rates in many DTC programs, it’s difficult to conclude at this stage whether or not drug courts result in decreased drug use and/or recidivism. More alarmingly, these authors found that women are less likely to apply to DTC’s and less likely to graduate at comparable levels to men, partly due to a lack of gender specific programming and program flexibility that accommodates parenting responsibilities. Indigenous women and men are also less likely to complete drug court programs due in part to the lack of Indigenous-specific treatment services.
Download the report
The report’s authors question how voluntary the entry to treatment is when prison is the alternative and access to other treatments are limited. As stated in the report,
“given the difficulty of obtaining drug treatment and social services without going through the DTC system, it is questionable whether a person is voluntarily entering DTC.”
The authors also point out that a DTC system can potentially undermine some of the safeguards of the traditional judicial system. Drug courts may also violate human rights, specifically, the right to health outlined in Article 12 of the International Covenant on Civil and Political Rights because participants can be denied access to a health service if they do not follow the rules of a DTC program.
Overall, this report questions whether dedicating limited resources to quasi-compulsory drug treatment via the criminal justice system, rather than scaling up access to quality voluntary treatment, is the best way to help people limit their drug use and prevent recidivism.
On June 26th, the Global Commission on Drug Policy released a groundbreaking report on the war on drugs and its failures. Titled “The war on drugs and HIV/AIDS: How the criminalization of drugs fuels the global pandemic”, the report focuses on the relationship between drug policy and the spread of HIV.
Global Commission Report Launch with Michel Kazatchkine, Ruth Dreifuss and Ilona Szabó
Covering a range of issues directly connected to the HIV and AIDS pandemic, the report points out the inability of law enforcement to reduce global drug supply. In fact, the global supply of illicit opiates, such as heroin, has increased by 380% in recent decades. And it describes how repressive drug control policies actually drive the HIV epidemic in many regions of the world. The report also details how policies that prohibit needle exchange increase syringe sharing and the risk of HIV infections, and how the fear of arrest drives people underground and away from needed services. It urges countries to scale up proven drug treatment and public health measures, including harm reduction services, to reduce HIV infection and protect community health and safety.
Canada often prides itself on being a positive and progressive force on the international stage. But politics, rather than evidence, tend to be the deciding factor in defining Canadian drug policy. As the Global Commission’s report explains, mass incarceration also drives the HIV pandemic. The recent passage of the Omnibus Crime Legislation prescribes mandatory minimum penalties for some drug crimes. This will have the effect of driving up incarceration rates in Canada’s already crowded prisons, and as the Canadian HIV/AIDs Legal Network recently pointed out, the lack of needle exchange programs in Canadian prisons contributes to the spread of HIV and endangers public health.
The report also documents how the fight against HIV is being won in countries where problematic substance use is treated as a health issue. In Australia and European countries such as Portugal and Switzerland, newly diagnosed HIV infections have been nearly eliminated among people who use drugs.
The Global Commission members are no lightweights when it comes the development of governmental policy. The Commission comprises a distinguished group of high-level leaders whose ranks include George Schultz, former US Secretary of State, Richard Branson, founder of the Virgin Group and advocate for social causes, and Ruth Dreifuss, former President of Switzerland, among many others.
This is the second report released by the Global Commission. Its first report, released in June 2011, catalyzed international debate about the urgent need for fundamental reforms of the global drug prohibition regime. It recommended implementing reforms such as alternatives to prison, a greater emphasis on health approaches to drug use, decriminalization, and experiments in drug regulation that avoid the negative effects of full prohibition.
With widespread media coverage around the world, the report has pushed the topic of drug policy reform back into focus just in time for the International AIDS 2012 Conference, taking place in Washington, DC, later this month. Stressing the need for urgent action, the Global Commission makes a number of recommendations to world leaders and the United Nations, the most fundamental of which being that they acknowledge and address the causal link between the war on drugs and the spread of HIV.
For more information see:
Global Commission on Drug Policy: http://www.globalcommissionondrugs.org/
Canadian HIV/AIDS Legal Network: http://www.aidslaw.ca/EN/index.htm
The past three months have been a blur of activity as we further establish our presence and connect with organizations and individuals across the country and around the world. There truly is something bigger going on and momentum is building towards considering new and innovative approaches to addressing drug problems.
Mexico Unido Contra la Delincuencia
In February, I was invited to speak at an international conference in Mexico City – Drogas: Un balance a un siglo de su prohicion, organized by the crime prevention group Mexico Unido Contra la Delincuencia. The forum provided a thorough consideration of possible alternatives to the devastating consequences of the Mexican government’s war on drugs. Speakers came from around the world to share stories of innovation, legislative changes and practices that have moved their drug policies towards a public health approach and away from a failed criminal justice model.
Integrating Supervised Injection Into Health Services and Community: A National Knowledge Exchange
CAHR 2012 Montréal
In April, CDPC organized a forum on supervised injection services in partnership with the Dr. Peter Centre in Vancouver and Cactus Montreal as an ancillary event at the Canadian Association of HIV Research meeting in Montreal. The event was held in the beautiful Biblioteque et Archive National du Quebec and was a chance for organizations to share their experiences and review the current state of the discussion in their jurisdictions. CDPC will be working with a number of organizations to keep this national discussion moving forward as different localities explore implementing these services.
North American Drug Strategy Meeting – San Francisco, April 12, 13
San Fransisco
As part of CDPC’s international work we co-hosted a meeting in partnership with the Drug Policy Alliance in the US and CUPHID from Mexico City to explore the development of a coordinated North American drug policy dialogue. The San Francisco meeting was the initial exploratory session to see how we can work together to bring forward alternatives to North America’s current drug policies. In an effort to strengthen our ties across the continent, CDPC is currently looking for Canadian allies interested in supporting our work in Mexico.
Visit to the Maritimes
People & Policies Conference Halifax
As part of our ongoing efforts to build a national coalition I visited Atlantic Canada in May, attending events and meetings in Halifax, Saint John, New Brunswick and Charlottetown. Atlantic Harm Reduction Research Network invited CDPC to be a part of their public session – People and Policies: How do Drug Policies Impact the Health of our Communities? In addition to this, a day-long session with service providers and researchers also considered how best to integrate harm reduction services into shelter and emergency ward settings.
In Saint John, NB, AIDS Saint John, the Urban and Community Studies Institute at University of New Brunswick and CDPC co-hosted an event – Drugs and the City, which featured a panel discussion on drug policy with Tim Christie, Ethics Director, Saint John Health Region and Bill Reid, Chief of Saint John Police Department.
In Charlottetown, I met with a number of parents who are concerned about the lack of youth treatment on the Island and are interested in organizing a provincial “addictions movement” to generate discussion, share experiences and engage the provincial government in dialogue on improving services for people with drug problems.
Thunder Bay Municipal Drug Strategy
Pot, Pills and Parties Thunder Bay
On May 24th Canadian Students for Sensible Drug Policy and Thunder Bay Drug Strategy put on the event – Pot, Pills and Parties. The event focused on the impact of Bill C-10 on young people and included a presentation from CDPC – Changing the Frame: A New Approach to Drug Policy in Canada.
As CDPC reaches out across the country we are finding new and innovative ways to strengthen and build our national coalition to improve Canada’s approach to drug problems. We will continue to engage Canadians and work at the international level towards this end.
Photo Credits:
Mexico – Steve Rolles
Montréal – Caroline Mousseau
San Fransisco – CC Flickr evoo73
Halifax – Wooden Shoe Photography
That’s the intention of Canada’s federal government.
Namely, to include methylenedioxypyrovalerone (MDPV), a synthetic substance that causes stimulant-like psychoactive effects, in Schedule I of the Controlled Drugs and Substances Act. At least that’s the proposal formally announced in the Canada Gazette on June 9, 2012. This follows Health Minister Leona Aglukkaq’s announcement that the drug would be banned because of “recent media reports [that] have linked the use of ‘bath salts’ to violence causing harm.” Interested parties have until July 8, 2012 to comment (details below).
Rather, it’s the common name given to MDPV, one of the possible ingredients in a substance available for sale, but as of yet, not regulated in Canada, unlike many of its amphetamine-like cousins already prohibited in Schedule III.
The government’s claim that bath salts are linked to violence stems from highly sensationalistic reporting of a tragic assault case in Miami where a man was shot and killed by police while apparently eating the face of another man. Miami police officials speculated that this attack was caused by the use of bath salts, though toxicology tests won’t be ready for a few weeks. Nor do they care that the man at the centre of this story had a history of violence, according to Kate Heartfield in the Ottawa Citizen.
The move to ban MDPV comes amid a news cycle in which numerous stories purport to detail the effects of its use, including a segment of CBC’s The Current with Anna Maria Tremonti on May 30th. The Current marshaled interviews from Halifax with a former bath salts user and an addictions treatment doctor to underscore the supposedly uniquely dangerous effects of this drug and give it a homegrown spin. Sound familiar? It should. Similar “drug scare” narratives have been constructed around the popularization of numerous substances, including crystal meth, PCP, crack, speed, LSD, heroin, reefer and of course, opium.
The rush to ban MDPV and place it in Schedule I will mean that the harshest drug law penalties can be applied to people who use, traffic or produce this drug. As researchers have noted, the banning of drugs like Mephedrone often drives its use and manufacture further underground, inflates the price and prevents the implementation of potentially helpful forms of regulation. Prohibiting substances has not made people safer, and has not resulted in the elimination of drug use. It can also displace drug use back to traditional illegal drugs, or to newer, potentially more dangerous “legal highs.”
We don’t want to ignore the voices of people who have negative experiences with MDPV but neither do we want to rush to ban this drug. In this case, it’s a political response that can placate worried voters but it also alleviates politicians of the responsibility to meaningfully address the underlying causes of problematic substance use. We urge you to express your concerns about this ban.
Comments on this proposed change can be directed to Mr. Nathan Isotalo, Regulatory Policy Division, Office of Controlled Substances, Address Locator: 3503D, 123 Slater Street, Ottawa, Ontario K1A 0K9, by fax at 613-946-4224 or by email at OCS_regulatorypolicy-BSC_ [email protected].
For more information see: Curiosity killed M-Cat: A post-legislative study on mephedrone use in Ireland, Marie Claire Van Hout1 & Rebekah Brennan. Drugs: education, prevention and policy, April 2012; 19(2): 156–162.
Nurses from across the country will be gathering in Vancouver at the Canadian Nurses Association Biennial Convention this week. As part of the occasion Insite and the Dr Peter Centre are each hosting special sessions on June 17th, providing opportunities for knowledge exchange on harm reduction policies and nursing practice.
Canadian nurses recognize that substance use, both legal and illegal, is an enduring feature of human existence and that abstinence is not always a realistic goal. As such, nurses focus on reducing adverse consequences and building non-judgmental, supportive relationships for the health and safety of individuals, families and communities.
There is a risk that the image of nurse-supervised injection is limited to a nurse hovering over a client while the injection takes place and nothing more occurs. I want to dispel this image.
The nurses of Insite have articulated their framework of nursing practice. Nursing care is client-centred with the focus on relationship building, maintaining dignity and respect, and creating an environment of cultural safety and empowerment. Primary nursing care at Insite includes safer injection education, needle-syringe exchange, first aid, wound care, overdose management, addiction treatment, reproductive health services and communicable disease prevention. These services are delivered as comprehensive harm reduction and health promotion programming nested in partnerships with the health and social service systems and community agencies.
Considering this it really shouldn’t come as a surprise that Canadian nurses support harm reduction services. The origins of outreach nursing have been attributed to the Grey Nuns, founded by Marguerite d’Youville in Montreal, who by the mid 1700’s, were known for their care to the destitute. Inequity of access to health care and the basic determinants of health has led to “street nursing” practices in many urban centres.
In Vancouver, after World War II nurses led a major effort to reach marginalized people who would not attend hospitals for the treatment of sexually transmitted diseases. In 1988 the BC Centre for Disease Control established the AIDS Prevention Street Nurse Program with a focus on needle and syringe exchange. With the epidemics of overdose deaths and the dramatic outbreak of HIV that Vancouver experienced in the 1990’s, the street nurses were some of the first to advocate for bringing injecting from the alleys into the safety of a supervised injection health service.
60,000 killed, 10,000 disappeared and 160,000 displaced.
As the 
The rush to ban MDPV and place it in Schedule I will mean that the harshest drug law penalties can be applied to people who use, traffic or produce this drug. As researchers have noted, the banning of drugs like Mephedrone often drives its use and manufacture further underground, inflates the price and prevents the implementation of potentially helpful forms of regulation. Prohibiting substances has not made people safer, and has not resulted in the elimination of drug use. It can also displace drug use back to traditional illegal drugs, or to newer, potentially more dangerous “legal highs.”
